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News that flu vaccines are much less reliable than previously thought is causing a stir in
public-health circles and prompting urgent calls for a better way to protect people from the
virus.

An analysis by the Center for Infectious Disease Research and Policy at the University of
Minnesota has concluded that flu shots aren’t as effective as most vaccines, offering only about 59
percent effectiveness in adults ages 18 to 64. The effort found “a paucity” of evidence of
protection for those 65 or older, who are at higher risk of complications and death, and
inconsistent evidence of protection in children.

Historically, public-health officials, including those at the U.S. Centers for Disease Control
and Prevention, have said that flu vaccine is 70 to 90 percent effective, based on studies that the
Minnesota group says are flawed.

Experts maintain that the shots are safe, useful and the best existing protection against the
virus, which kills anywhere from 3,000 to 49,000 Americans each year. Their message: We need to do
better, but don’t use this news to justify skipping the flu shot.

“We need a better vaccine,” said Dr. Teresa Long, Columbus health commissioner. “In no way
should we back off of getting the protection that is offered; we just need to understand it
better."

Dr. Michael Osterholm, who formerly worked at the CDC, led the new analysis. It is one of the
most-comprehensive reviews of a vaccine’s effectiveness ever done and included evaluations of
12,000 publications on flu vaccine and interviews with almost 100 experts.

“We can no longer accept the status quo regarding vaccine research and development,” wrote
Osterholm in a preface to his group’s report. “We hope that our efforts will serve as a catalyst to
rapidly move the international influenza enterprise closer to developing game-changing influenza
vaccines.”

Previous overestimations of how well the vaccine worked might have stalled progress on newer
vaccines, he and others have said.

In recent years, federal officials have recommended that an increasingly large number of
Americans get the vaccine, suggesting it now for almost everyone over 6 months old. The report says
those recommendations were based on professional judgment, not scientifically sound data.

An ideal vaccine would prompt an immune response to many strains of influenza, offering
recipients more-comprehensive protection over a longer term, perhaps five or 10 years, said Dr.
Mary DiOrio, state epidemiologist at the Ohio Department of Health.

“I think this really should heighten the awareness that we really need to look at developing a
new vaccine,” she said.

There are significant obstacles. Bringing a new vaccine to market can take 15 years and cost
more than $1 billion, according to the report.

Experimental products are being investigated now. A more-potent vaccine is available for senior
citizens, but it’s unclear if the increased immune response to the vaccine will mean fewer
illnesses and deaths.

And a couple of new products aimed at more than three strains of flu recently were approved.
Now, annual flu vaccines are designed to provide protection against the three strains most likely
to infect us in a given year.

For now, Long said, it makes sense to continue vaccinations and to emphasize vaccinating
children, who tend to have the most-robust response. If enough kids are protected (and enough
adults get vaccinated even with the limited efficacy), it should increase the overall protection
against the spread of flu to all Americans, a concept known as “herd immunity.”

Dr. Julie Mangino, an infectious-disease expert at Ohio State University’s Wexner Medical
Center, agreed that a focus on vaccinating children makes sense because of the potential for a
better response to the vaccine and for other reasons.

“They are probably less likely to cover their cough and sneeze into a tissue and wash their
hands as frequently as they should,” she said.

Mangino, who like other experts is eager for a better vaccine, said she encourages everyone, not
just kids, to continue to get the flu shots that are available.

“The vaccine is still really one of the best weapons we have to prevent influenza,” she said. “
It’s still our best defense.”

Flu season in Ohio already has begun. Activity was considered sporadic as of mid-November.
Infections typically escalate around the holidays as more people gather together indoors. Vaccine
is widely available this year.